Multiple intracranial metastases from postoperative giant sarcomatoid malignant pleural mesothelioma: A case report and literature review

Our plain-English summary of Multiple intracranial metastases from postoperative giant sarcomatoid malignant pleural mesothelioma: A case report and literature review, by D. Tian, H. Wen, H.E. Brown, et al (Molecular and Clinical Oncology, 2018).

The study

• Authors: D. Tian, H. Wen, H.E. Brown, X. Wang, L. Zhang, M. Fu
• Journal: Molecular and Clinical Oncology
• Published: 2018;8(1):34-37
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Sarcomatoid malignant pleural mesothelioma (SMPM) is a rare tumor with poor response to treatment and a dismal prognosis. Distant metastases are not uncommon and usually appear at the late stages of the disease. However, cerebral metastases have rarely been documented. We herein report a case of a giant sarcomatoid carcinoma of the pleura in a 41-year-old male patient with no history of exposure to asbestos, who presented with a chief complaint of left-sided chest pain for 1 month. Extrapleural pneumonectomy and rib excision were performed. At 5 months after the surgery, the patient was diagnosed with multiple intracranial metastatic neoplasms and succumbed to the disease soon thereafter. The aim of the present case report was to emphasize this rare metastatic pattern and aggressive clinical course of SMPM, with a supplementary review of the previously published literature.

In plain English

This article is a case report with a short review of earlier published cases. The authors described a 41-year-old male non-smoker seen at the Affiliated Hospital of North Sichuan Medical College in Nanchong, China, in 2016, who had left-sided chest pain for one month. The article reports that he had no past history of exposure to carcinogenic chemicals such as asbestos. A needle biopsy before surgery did not give a significant result. Surgeons performed an extrapleural pneumonectomy, removing the lung together with the pleura, and the tumor measured about 12 by 10 by 8 cm. Tissue tests were consistent with sarcomatoid malignant pleural mesothelioma, a rare subtype. No chemotherapy followed surgery because of financial difficulties. Five months after surgery, the tumor had returned at the surgical site and a brain scan showed four metastatic lesions. The patient was discharged without treatment and died one week later. The authors noted only one earlier reported case of multiple brain metastases from this subtype. They concluded that the case emphasizes its rare metastatic pattern, aggressive course and poor response to treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report with a brief literature review (a table of previously published cases of sarcomatoid malignant pleural mesothelioma)
• Who was studied: one 41-year-old male patient, a non-smoker, treated at the Affiliated Hospital of North Sichuan Medical College, Nanchong, China, in 2016
• Exposure: the article reports no past history of exposure to carcinogenic chemicals such as asbestos; the patient was a non-smoker
• Main results:
  • a CT-guided needle biopsy of the mass before surgery did not give significant findings
  • at surgery (extrapleural pneumonectomy) the solid tumor measured about 12x10x8 cm
  • microscope and immunohistochemistry findings, including negative calretinin, were consistent with sarcomatoid malignant pleural mesothelioma
  • no chemotherapy was given after surgery because of financial difficulties
  • five months after surgery, CT showed recurrence at the surgical site and 4 intracranial metastatic lesions
  • the patient was discharged without treatment and died 1 week later
  • the authors' literature review found only 1 previously reported case of multiple intracranial metastases from this subtype
• The authors' conclusion: The authors concluded that the case emphasizes the rare metastatic pattern, aggressive clinical course and poor response to treatment of sarcomatoid malignant pleural mesothelioma

Topics

Medical terms in this study, explained in our Lexicon: Sarcomatoid, Pleural Mesothelioma, Prognosis, Carcinoma, Pleura, Extrapleural Pneumonectomy (EPP), Neoplasm.

Related studies

• Peritoneal malignant mesothelioma with multiple distant skin metastases — N.G. Ordóñez, J.L. Smith (1983)
• Multiple skeletal muscle metastases from malignant pleural mesothelioma — W. Grellner, M. Staak (1995)
• Multiple distant metastases in a case of malignant pleural mesothelioma — K.C. Tertemiz, A. Ozgen Alpaydin, et al. (2014)
• Choroid plexus metastases from pleural sarcomatoid mesothelioma — A. Muljono, T. Ng, et al. (2008)
• Primary pleural epithelioid haemangioendothelioma with metastases to the skin. A case report and literature review — M. Al-Shraim, B. Mahboub, et al. (2005)
• Brain metastases in malignant pleural mesothelioma. Case report and review of the literature — K.S. Sridhar, A.M. Hussein, et al. (1989)

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